BREAST CANCER EXPERT FORUM
breast cancer and hystectomy

breast cancer and hystectomy

I am a 48 yr old female  recently diagnosed with invasive lobular carcinoma of the right breast which was undetected on mammogram.  I chose to have bilateral mastectomies with insertion of tissue expanders for reconstruction.  Tumor size was 3x3 cm. Sentinel lymphnodes were positive 4/5 for total 9/11.  Hormone tests were also positive.  The left breast was negative.  I am now facing chemo - 9 courses (adriamycin, cytoxan, and 5FU) followed by  hysterectomy with removal of ovaries, chest wall radiation followed by 4 courses of taxotere.  If the tumor is estrogen driven, is it wiser to have the hystectomy first and then chemo?  I do realize that a possible surgical complication might further delay the start of chemotherapy.   I would greatly appreciate your experts opinion on this question and if possible the treatment course I have outlined above.
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Dear boysqbd:  In general, it is advisable to start chemotherapy and not incur further delays by proceding with an "elective" surgery.  In most cases, removing the ovaries is not standard of care, although it can and is done in some situations.  The current standard of care is to use tamoxifen after chemotherapy and radiation in premenopausal women.  In post-menopausal women, some physicians prefer to use anastrozole.
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